Abstract
The typhoidal Salmonellae were controlled in cities in North America and Europe in the late 19th and early 20th century by development of centralized water treatment systems. In the early 21st century, large urban centers where drinking water routinely mixes with human feces have the highest burden of typhoid fever. Although improving municipal drinking water quality is the most robust approach to reduce enteric fever burden, the high costs and managerial capacity that such systems require and decreasing per capita water availability requires new approaches to reach the highest risk communities. The spread of antimicrobial resistance threatens to increase the burden of enteric fever much sooner than the extension of safe reliable water service delivery can be implemented. Thus, vaccination is an important interim measure.
Highlights
The typhoidal Salmonellae were controlled in cities in North America and Europe in the late 19th and early 20th century by development of centralized water treatment systems
In the late 19th century after cities across the United States and Europe implemented initial strategies to improve the microbiological quality of their drinking water, deaths from typhoid fever dropped immediately by a mean of 78% [1, 2]
Subsequent progressive improvements in the microbiological quality of municipal drinking water quality were associated with progressive reductions in typhoid fever incidence [3]
Summary
Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California. The typhoidal Salmonellae were controlled in cities in North America and Europe in the late 19th and early 20th century by development of centralized water treatment systems. In the early 21st century, large urban centers where drinking water routinely mixes with human feces have the highest burden of typhoid fever. Improving municipal drinking water quality is the most robust approach to reduce enteric fever burden, the high costs and managerial capacity that such systems require and decreasing per capita water availability requires new approaches to reach the highest risk communities. The spread of antimicrobial resistance threatens to increase the burden of enteric fever much sooner than the extension of safe reliable water service delivery can be implemented. Drinking water; poverty areas; typhoid fever; vaccines; water purification
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